[The relationship between tissue type plasminogen activator therapy and ventricular late potentials in acute...

We studied the relationship between thrombolysis and late potentials (LP) in 137 patients with acute myocardial infarction (AMI). Among 37 patients treated with tissue-type plasminogen activator(t-PA treated group), LP were recorded in 2 patients (5%). In contrast, among 100 conventionally treated patients (control group), LP were seen in 26 (26%, P less than 0.01). When the two groups were matched with respect to age, sex, absence of prior infarction, LVEF, number of abnormal Q waves, ECG score and CAD score, the same incidence of LP was seen, i.e. 6% of the 34 t-PA treated patients had LP as compared with 24% of the 42 conventionally treated patients (P less than 0.05). Angiographic examination following t-PA infusion revealed that the incidence of LP was 0% and 40% in patients with patent and closed infarct-related coronary artery respectively. 1 year follow-up data showed that no deaths occurred in the t-PA treated group, while in the control group. 18 deaths were recorded and 8 of them were classified as sudden death. These observations suggest that patients with AMI treated early with thrombolysis have electrically more stable ventricles due to improvement of ischemia.